Introduction: Home parenteral nutrition (HPN) and all the complications related to it, used to be the only option in patients with intestinal failure. Nowadays small bowel transplant (SBT) is an answer to these patients.

Methods: From December 2004 to January 2019 we have assessed 105 patients as potential candidates, the majority of them not eligible; and have performed 31 transplants in 29 patients (21 IT and 8 MVT).

Results:

Short bowel syndrome (SBS) was found in 60% (18/29) of the patients.

Potential candidates for SMT were malnourished, with a mean pretransplant BMI of 22.2, average weight of 61.6kg and pre albumin values around 21.7mg/dl. 64% of the patients required total HPN before the SBT and almost 86% had several HPN-related complications due to it ( 6% thrombosis of major venous access, 37% catheter -related infections, 28% sepsis, refractory balance alterations.

After SBT the patients in our study reached a mean BMI of 23.7,mean weight of 67.8kg and pre albumin values around 26.7mg/dl. All recipients achieved satisfactory oral nutritionat about post-transplant day 12. Almost 80% of the patients required parenteral nutrition support during the first two months post-transplantation.

SBT recipients will need some form of parenteral nutrition support for an average period of 27 months including the time before and after the SBT.

One year after undergoing transplantation, all recipiets will achieve a complete digestive autonomy and only 8,3% will need fluid replacement therapy.

Conclusions: Small bowel transplantation is a life-saving procedure for patients with intestinal failure who develop complications related to parenteral nutrition, and it is the most effective treatment in terms of complete digestive autonomy acquisition for these patients